Quebec’s euthanasia law came into effect three years ago, in December 2015. Since then, 1,664 Québécois have been euthanised, according to a report tabled in the Quebec parliament. A total of 845 persons were euthanised in the 9 months from July 2017 to March 2018, compared to 638 for the 12 months from July 2016 to June 2017.
Oddly enough, the reporting periods are quite different. A better way to compare them, then, (pending clarification) is by month. On a monthly basis the number of people who received “medical aid in dying” in Quebec rose from 53 per month in 2017 to 93 in 2018, an increase of 75%.
The latest report indicates that 10% of the reported euthanasia deaths were not administered according to the letter of the law. Either the paperwork was incomplete or the law had apparently been broken. The corresponding figure for the previous period was 8%. The report stresses, however, that the “great majority” of the euthanasia deaths were administered according to the law.
More news about how Quebec doctors observe the province’s medical-aid-in-dying (MAiD) law comes from the Journal of Medical Ethics. In an article which appeared online on November 22, three bioethicists from Quebec report that MAiD is becoming a first, rather than a last resort for patients:
Despite professional practice guidelines stipulating that MAiD should be treated as an option of last recourse, in some cases, requests for MAID serve instead as instigators for discussion about end-of-life care, including discussion and initiation of treatment limitations and a palliative care approach. Requests for and provision of MAiD as documented in the chart can occur abruptly and without a documented evolution of the goals of care which may imply that requests for MAiD are not treated as having particular moral considerations but merely administrative or legal ones.
If MAiD is not ethically distinct from other end-of life practices, then the timing would not appear to add any additional ethical concerns to those already expressed in relation to late discussion of end-of-life care options in general.
If, however, MAiD is ethically distinct and should be treated with special consideration, the tendency to avoid, delay or have inadequate conversations about end-of-life care may be especially troubling in the context of their unknown impact on requests for assisted death.
They say that requests for MAiD need to be investigated.
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